Laser Doppler Flowmetry as a Predictive Tool for Poor Venous Flow in Leukapheresis

Poor venous flow during leukapheresis may compromise cell collection; however, reliable predictors remain limited. We retrospectively analyzed 146 leukapheresis procedures involving patients with hematologic malignancies (n = 79) and healthy donors (n = 67) at two institutions, with continuous monitoring of peripheral blood flow using laser Doppler flowmetry (LDF). Poor venous flow, defined in this study as persistent low inlet pressure requiring a > 10% reduction in the draw rate to continue leukapheresis, occurred in 29.1% of patients and 26.9% of donors. In patients, multiple myeloma, lower baseline blood flow, and higher pulse amplitude were independently associated with poor venous flow, whereas in donors, older age was an independent predictor. Peripheral blood flow decreased at the onset of poor venous flow without concomitant changes in blood pressure or LDF-derived pulse rate. These findings suggest that LDF may help predict poor venous flow during leukapheresis and support pre-procedural risk stratification.